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Deie ~ I Lot No. ~ I Block I Ward I Addition or Replat
OUTSIDE WORK
Naw SEW" WAlE. STORMS FEES FEES .ELAY S. SEWER WAlE. STORMS FEES
From MaID to Curb Septic Tanks From Main to Curb
hom Curb to Building Electric Pump. From Curb to Building
Repair
INSIDE WORK
NO. NEW RIP. USED FlES NO. NEW .EP. USED FEES NO. NEW .EP. USED FEES
/ riD - ~ - -
_Tub Gubage Diopooa1o Catch Buw
/ /(7' ;¡ -
Wub Buin Dlohwuhero Conductoro
J~ !~ - /~ - -
Weier CIOl8t / Laundzamatl / Greue Ceich Buw
'/ jp-~ / I--
Sink Weier Softenero Sump Pump k Ejectors L
W8ier Heeien j /f7Ò Sanitary Bubblero Bu and Soda Wute.
Shower BUho Urilla1o
Floœ Dralu / /fY!J Dental Cu.pidon
, -
Laundrr Tubo Service Sinko
Inopectiono Valuation Df the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Fe..
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~::----~l~\i===~~~~~ - -~- _~_--~mmPlbg. Fe..
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In the performlnce of this work the undersigned ownlr (or his luthorired agent) of slid premises Ind his authorized Plumber hlreby agree to be bounden by and
submit to all stltutes, city ordinlnces, and rules Ind regulltions prescribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned thlt no other uses will be made of the above connections e~apt as he.rei_nlftar listed.
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